杨成 李正勇 刘睿奇

[摘要]目的：比較耳软骨联合硅胶假体与肋软骨联合硅胶假体隆鼻的应用效果。方法：收集2017年7月1日-2018年12月31日笔者医院收治的鼻整形患者160例，随机按1：1比例分为对照组（n=80）与观察组（n=80），对照组采取耳软骨联合硅胶假体隆鼻，观察组采取肋软骨联合硅胶假体隆鼻，比较两组患者手术时间与愈合时间，术后随访6个月比较两组鼻整形效果满意度，鼻部外观相关指标改善情况以及并发症发生的变化情况。结果：两组手术时间与愈合时间比较差异无统计学意义（P>0.05）。术后随访6个月，两组鼻唇角、鼻额角、鼻尖长度、鼻尖突出率以及面部突出度明显改善，差异有统计学意义（P<0.05）;观察组鼻唇角、鼻尖突出率以及面部突出度改善幅度更佳，差异具有统计学意义（P<0.05）。观察组并发症发生率为3.75%低于对照组的15.00%，总满意度为93.75%明显高于对照组的77.50%，差异有统计学意义（P<0.05）。结论：肋软骨联合硅胶假体隆鼻相比于耳软骨联合硅胶假体在鼻部整形美学角度改善方面具有更好的效果，术后并发症少，值得临床推广。

[关键词]鼻整形;肋软骨;耳软骨;硅胶假体;美学效果

[中图分类号]R622    [文献标志码]A    [文章编号]1008-6455（2020）04-0028-04

Abstract： Objective  To compare the effect of auricular cartilage combined with silicone prosthesis and costal cartilage combined with silicone prosthesis in rhinoplasty. Methods  A total of 160 patients who underwent rhinoplasty admitted to our hospital from July 1， 2017 to December 31， 2018 were collected and randomly divided into the control group （n=80） and the observation group （n=80） in a 1：1 ratio. The control group was given auricular cartilage combined with silicone prosthetic rhinoplasty， and the observation group was given costal cartilage combined with silicone prosthesis rhinoplasty. The operative time and healing time， and satisfaction of rhinoplasty effects and improvement of nasal appearance-related indicators at 6 months of follow-up after operation， the improvement of nasal appearance-related indicators and changes of occurrence of complications were compared between the two groups. Results  There was no significant difference in operation time and healing time between the two groups（P>0.05）. After 6 months follow-up， the nasolabial angle， nasal frontal angle， nasal tip length， nasal tip protrusion rate and facial protrusion of the two groups were significantly improved， the differences were statistically significant（P<0.05）. The improvement of nasolabial angle， nasal tip protrusion and facial protrusion was better in the observation group（P<0.05）. The incidence of complications in the observation group was 3.75%， which was lower than that in the control group（15.00%， P<0.05）. The total satisfaction rate in the observation group was 93.75%， which was significantly higher than that in the control group（77.50%， P<0.05）. Conclusion  The costal cartilage combined with silicone prosthesis is better than the auricular cartilage combined with silicone prosthesis in improving the aesthetic angle of rhinoplasty， with fewer postoperative complications， which is worthy of clinical promotion.

Key words： rhinoplasty; costal cartilage; auricular cartilage; silicone prosthesis; aesthetic effect

鼻整形术是美容外科中最为多见的一种手术[1]。近年来，随着医学的发展，鼻整形的方式越来越多样化，其目的都是为了获得更好的鼻尖凸度，鼻整形的关键就在于利用耳软骨、肋软骨及鼻中隔软骨组织等对鼻部形态进行重塑[2]。单纯利用硅胶假体进行鼻整形术后并发症发生率高，联合使用耳软骨、肋软骨及鼻中隔软骨组织等逐渐成为鼻整形领域的研究热点[3]。耳软骨联合硅胶假体与肋软骨联合硅胶假体隆鼻是现今使用比较多，成功率比较高的两种鼻整形手术，但是各有优缺点[4-5]。本研究选择160例鼻整形患者，探讨耳软骨联合硅胶假体与肋软骨联合硅胶假体隆鼻的应用效果，报道如下。